Individual
MS. KELLEY EILEEN BRISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
351 BOSQUE BEND LN, CHINA SPRING, TX 76633-2753
(254) 749-1398
Mailing address
351 BOSQUE BEND LN, CHINA SPRING, TX 76633-2753
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016465
TX
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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